Here in Part One, I describe what Obamacare gets RIGHT.
In Part 2 of this blog, I outlined where Obamacare falls short and is in desperate need of repair.
View Part Two Here: https://scottmcmurrain.blogspot.com/2017/04/the-truth-about-obama-trump-care-part.html
In Part 3 of this blog, I recommend SOLUTIONS. Anybody can complain about what is wrong with the system, but any solution needs to start with some fresh IDEAS, and here are mine.
View Part Three Here: https://scottmcmurrain.blogspot.com/2017/04/the-truth-about-obama-trump-care-part.html
PART ONE
The pending health care bill being pushed through Congress is a disaster waiting to happen!
To see why, let’s look at the major provisions of this bill:
First, it replaces the subsidies under Obamacare with flat tax credits based on age. Why ANY Republican would support such a scheme is beyond me. The subsidies under Obamacare were designed to require the each American pay as much as they can afford, and then the Federal Government would make up the difference. What could be more fair than this? If makes people PAY for their own healthcare, while realizing that it is simply not possible for many people to pay the entire cost. The subsidies ensure that the Government pays ONLY what is necessary for people to get insurance. The TrumpCare plan, on the other hand, creates an entitlement for ALL Americans, whether they need the assistance or not. A wealthy 50 year old who makes more than enough to pay for his own insurance will get $4,000 FREE from the government, while a poor person will see a subsidy of $12,000 replaced with $4,000. The rich guy gets an extra $4,000 he did not have before, but the poor guy is forced to pay an extra $8,000 that he cannot afford to pay even if he wanted to. So he loses his insurance. (And also loses the $4,000 when he drops his insurance).
Second, TrumpCare cripples Medicaid. Currently, there is a minimum level of service required to be provided to every recipient. The Federal Government pays the vast majority of each State’s cost. Under TrumpCare, the Federal Government will simply pay a fixed amount to each State, regardless of what the State actually spends. This amount will be LESS than what it currently pays. TrumpCare justifies this by telling the States they no longer have to provide this MINIMUM level of service. They can choose whatever services they want to provide, and are free to eliminate any services they don’t want to pay for. While the GOP touts this as “Giving the power back to the States”, what it really does is force each State to pay a lot more out of its own pocket, or to choose what services it can no longer afford to offer.
TrumpCare DOES save the Federal Government a LOT of money. But it does this by vastly increasing the burden on the middle class (less subsidies) and on the States (less Medicaid). Saving the Federal Government money is generally a good thing. But what does TrumpCare do with these savings? It gives ALL of the savings to the rich! It does this in four ways:
(1) It gives a tax credit of $2,000 to $4,000 to everybody,
(2) It reduces the Capital Gains Tax Rate for the rich,
(3) It reduces taxes paid by insurance companies, and
(4) It allows insurance companies to treat excessive executive salaries over $500,000 per year as ordinary expenses.
TrumpCare does NOTHING to address the real problems with Obamacare, namely the out-of-control health care costs. The GOP has mentioned several things that could indeed help, but this bill contains NONE of their ideas.
The GOP is claiming that this is only PHASE ONE, and that the other two phases to come later will fix the problems. DOES ANYBODY ACTUALLY BELIEVE THIS?
The GOP has not released ANY details of what Phases Two and Three will entail; only vague generalities. This is their BIG CON! The GOP knows that it cannot pass Phases Two and Three without SOME Democratic Support, and they have NONE at this time. Their only hope, which they cannot actually say out loud, is that the initial phase of TrumpCare will so decimate Obamacare that the entire system will fail spectacularly, leaving Democrats no choice by to acquiesce to their demands in order to restore ANY semblance of a working system.
But even the GOP is split over the TrumpCare bill. One faction in the party is opposed to the Federal Government offering an entitlement or subsidy to ANYBODY for health care. They see this as a form of Socialism (which it is) and are so opposed to it that they would rather see millions of people suffer without insurance. These are the ones who are claiming that TrumpCare is “Obamacare Lite”.
The other part of the GOP that opposes the plan realizes that it will result in MILLIONS of people losing their insurance, and, not only is they fundamentally wrong, it breaks the campaign promises the made last year. Remember, Trump said his health care plan would cover EVERYBODY? TrumpCare really does just the opposite.
The real problem is that law passed and signed by Obama was NOT the plan the Democrats wanted. They wanted a much more comprehensive solution similar to the one pushed by the Clintons back in the 1990’s. But they realized that they could never pass such a law because the GOP would oppose it. So, instead, they took the Republican’s own solution and ran with it. They reasoned that basing their law on a REPUBLICAN SYSTEM used in Massachusetts would have the support of the GOP, and a weaker bill that passed would still be better than a great bill that would never pass. Initially, they DID get some support. But then the GOP leadership’s hatred of Obama led them to dictate that the GOP would oppose ALL MAJOR legislation endorsed by the Democrats regardless of its merits.
It is vitally important to understand that OBAMACARE IS THE LAW THAT THE GOP REALLY WANTED. Obamacare FORCES people to take control over their own health care by making them buy their own insurance. It only provides subsidies AFTER people have bought insurance and paid for as much of it as they can afford out of their own pocket! Doesn’t forcing people to take responsibility for themselves seem much more of a Republican idea than a Democratic one?
SO WHY IS THE GOP DOING THIS?
The answer is simple: They promised to Repeal Obamacare, and this is as close as they can get without SOME Democratic Support. They drew a line in the sand, and are afraid that failing to pass any bill will be seen as a failure on their part. Since the law was passed under Obama without ANY Republican Support, the GOP leadership’s line in the sand was crossed, and they feel that they must destroy the law in order to save face.
I watched a Town Hall meeting with Tom Price this week and am totally disgusted with the repeated lies and misrepresentations he made throughout the show. These are the same lies being spread by most of the GOP this week.
(1) He repeatedly stated that, under Obamacare, that the government dictates what your health care choices are, and that the GOP plan returns control back to you and your doctor. THIS IS A LIE. Obamacare does NOT dictate what health care choices you and your doctor must undertake.
(2) In response to a lady who was upset that her policy included pediatric dental coverage when she did not have kids, he stated that Obamacare dictated what every policy offers and that the GOP plan would eliminate that. His response was both a major misrepresentation of Obamacare and an outright LIE about the GOP health plan. Let me explain: Obamacare does NOT dictate everything in a healthcare policy. Obamacare simply sets MINIMUM STANDARDS that every policy must cover. Insurance companies are free to add additional services or increase the coverage above and beyond these minimum services. The government sets minimum standards for many products. For example, when you buy a car in the U.S., the steering wheel is on the left, the brake pedal is in the middle, and the accelerator is to the right of the brake pedal. New cars must contain airbags. Etc. Etc. The government is NOT dictating what every car must be; it is simply setting minimum standards. Obamacare simply sets minimum standards, and calls these standards ESSENTIAL BENEFITS. Tom Price, and most of the GOP, are completely misrepresenting this issue. When Tom Price told the lady that the GOP plan would change this, that was a LIE. The GOP plan retains the Essential Benefits clause contained in Obamacare!
(3) Tom Price stated that the GOP plan would make insurance affordable to EVERY American. That LIE is so outrageous it’s almost beyond belief!
(4) The GOP continually states that Obamacare is a failure. Obamacare’s Primary Goal was to get coverage for the millions of uninsured Americans. Over TWENTY MILLION Americans now have coverage that did not before Obamacare. That hardly can be considered a failure. Of course, there are still Americans that are uninsured, but most of those are in the states where the State refused the expanded Medicaid offered.
BACK TO THE BASICS
The Democrats should never have passed the law without GOP support, even if it meant waiting a few more years to get the compromises worked out. They rushed out a law that DID enable millions to get health insurance, exactly as promised, but caused skyrocketing premiums as a result. Ironically, one of the key points in the law that was designed to control costs ended up being a major factor in the increases! Of course, the Republicans were just as guilty at the time because they did everything they could to delay and prevent the passing instead of trying to work with the Democrats and come up with compromises that would have worked for everybody.
If we are ever going to come up with a solution, we need to start from a point where we all agree. So, let's figure out exactly what it is that we all agree on:
First, let’s state the goals on which we ALL agree:
We ALL agree that nobody should DIE because they did not have insurance and/or could not afford health care.
We ALL agree that hospitals should not turn away emergency cases at the door because the patient cannot pay.
We ALL agree that people should take responsibility for their own health care. But, in order for that to happen, everybody must have the MEANS to be able to do that.
This was the FIRST and PRIMARY goal of Obamacare: It requires that insurance companies MUST ACCEPT everybody who signs up for one of their policies. This is something we ALL AGREE on. Every version of the GOP plan being discussed this week keeps this requirement.
Now, here is where the first major problem arises: If the insurance companies MUST accept all takers, then we MUST require that everybody be insured. If this require is removed, many people will choose NOT to carry insurance until they need it. They can wait until they are in the ambulance on the way to the hospital with a heart attack, and call their agent and sign up. They would pay one month’s premium, say $1,000, and the insurance company would be on the hook for $250,000 in hospital bills. Then they would cancel once they got released. NO INSURANCE COMPANY COULD SURVIVE. In order to pay ALL claims, there must be a large enough pool of insured to cover ALL the claims. The ONLY way to insure that is to require people to carry insurance. Obamacare does that. The GOP bill does NOT require that. Instead, it allows insurance companies to add 30% to someone’s bill for ONE YEAR. That hardly is an incentive. In our above example, instead of paying $1,000 to get $250,000 in benefits, they would have to pay $1,300 to get $250,000 in benefits. This is simple math. Anybody who has passed First Grade can see that.
Now that we know that we MUST require everybody to carry insurance, we now have a second major problem: Many people simply cannot afford to buy the insurance even if they wanted to. Obamacare came up with a great solution: It would guarantee that nobody would pay more than 12% of their income to buy insurance, based on the price of the second-lowest Silver Plan in their market. It did that pay paying the difference in the premiums directly to the insurance companies. Under Obamacare, those that can afford insurance pay for it, but those who cannot afford the full premiums still pay up to 12% of their income. I can’t think of a better solution. But the GOP wants to do away with these subsidies and just pay everybody a flat amount of money, based on their age. Income would only be a factor for high-income earners. THIS IS A HORRIBLE IDEA. For most people, this flat amount will be LESS that the subsidy they get now, which means that many people will NOT BE ABLE TO AFFORD insurance. If your premium is $12,000 per year and you earn $26,000, you would pay $3,120 per year for insurance under Obamacare, but under the GOP Plan, there is no way you can afford insurance even with a $2,000 or $4,000 flat amount. However, if you make $120,00 per year, you CAN afford to pay for it. So, under Obamacare, you do NOT get any subsidy. But, under the GOP plan, you DO GET MONEY! The GOP plans takes money from the poor and gives it to the rich!
THE REAL PROBLEM WITH OBAMACARE
All of the above parts of Obamacare are working exactly like they were designed, and should NOT be changed. What Obamacare does NOT do is control the skyrocketing COSTS of insurance. Trump has identified TWO major ways to help cut costs: Regulate the out-of-control drug costs and allow people to buy insurance across State lines. But the GOP plan does NOT address EITHER OF THESE THINGS, despite Trump’s promise that it would.
But they are so determined to pass SOMETHING they have chosen to use a loophole in the rules that will allow them to force a bill through under the “budget reconciliation” process. But this special loophole does NOT allow them address the REAL problems of skyrocketing costs. So they are changing the only parts that they can, EVEN THOUGH THEY ARE NOT BROKEN, just to be able to say that they DID repeal Obamacare!
The worst part of all of this is that the changes the GOP plan DOES MAKE WILL DESTROY OBAMACARE. Under the GOP plan, millions will lose their insurance because they can no longer afford. Any millions more will drop it because they can just wait until the need it. With millions dropping out of the pool, health costs will skyrocket like nothing we have ever seen, assuming any insurance companies even continue to write policies.
The really disgusting thing is that the GOP leaders know that ALL OF THIS IS TRUE.
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